Lollipop and Halo-halo Moments: Mindful and Intentional Self-care

 

It is not easy to be a nurse nowadays, not even for a staff nurse or a nurse leader. Amidst all these uncertainties, nurses struggle with the stressors of an increasingly demanding profession. Nurses hold the fabric of patient care in a stressful environment. What if the fabric is frayed at the edges? How can nurses take care of their patients when they need help themselves?

The job is emotionally exhausting, and we often try to continue caring for our patients to the point of burnout and, in some cases, clinical depression. We survived the Covid-19 pandemic four years ago, but it had an immense impact on our mental well-being. The statistics show a dire picture of post-traumatic stress disorder and suicides in the healthcare profession.

Mental Health and self-care

The American Academy of Nursing (AAN) Expert Panel issued their Consensus Statement in the spring of 2023 about the drivers of Nurse Suicide: the stigma associated with asking for and receiving treatment to support mental health, job-related stressors, and lack of access to mental health treatment.

The National Academy of Medicine suggested a bundled approach to sustaining a positive work environment, reducing the stigma for those seeking mental health care, and focusing on the mental well-being of healthcare workers.

On November 20-22, 2024, the 1199SEIU League of Registered Nurses held a nursing conference in Montego Bay, Jamaica, titled "Empathy in Action: Caring Beyond Ourselves and Honoring Self-care." I was honored to be one of the instructors. My topic was "Finding Your Joy by Finding Your Lollipop Moment."  It was a truly enriching experience to promote self-care and mental health to about 148 nurses who traveled to Jamaica. I dedicated my presentation to two of my former staff nurses who we lost to suicide.

Lollipop Moment

Although the topic was somber, it was uplifting as we discussed ways to find joy in our personal and professional lives. I encouraged the audience to share their "lollipop moment," which was originated by Drew Dudley, a dynamic leader, author, and inspirational TED Talk speaker. A “lollipop moment” is when someone said something or did something that fundamentally made your life better.

Nurses make a difference every day, but sometimes, they must be reminded about their lollipop moments. The nurses did not take long to share their proud moments of touching someone’s life, whether a patient or a fellow nurse. It was heartwarming when one participant thanked her mentor (who was also present) for her guidance and support during the COVID-19 pandemic.

One nurse approached me after the session to express how empowered and inspired she was. She acknowledged that she needed to hear all the instructors drive home the truth that nurses must place themselves at the forefront of mental health care.

Halo-halo moment

Then, I introduced my Halo-halo moment, when I pause and enjoy my comfort food, forget my a1c, and savor the incredible moment of finding joy in the simplest things. Halo-halo (“mix-mix”) is a popular cold dessert in the Philippines made up of crushed ice, evaporated milk, sweetened kidney beans, coconut strips, toasted rice, sago, leche flan, and ube ice cream. My son Jordan described it the best.

 

Caring beyond ourselves

We also went to a local school to distribute book bags to grade-school children, who welcomed our group with shy smiles but were eager to hug anyone who opened their arms to them. The group of nurses also visited churches and a local hospital to conduct community teaching on kidney health, managing severe bleeding, and maternity child health.

 

Mindful and Intentional

We must be mindful and intentional as we seek our moments of joy to keep our mental well-being. We must maintain our focus on strengthening the morale of our nurses. We need to help and support each other.

The Jamaica trip was restorative and invigorating. There were singing, dancing, and laughter. There was healing.

The nurses enjoyed the amenities of the inclusive resort but also ventured out of the hotel to experience other attractions. As Bob Marley sang, "One Love, one heart. Let's get together and feel all right".

Coler and Us... Through The Years

In the 1980's, the Pinoys invaded Roosevelt Island. Forty-one years ago, on this tiny island in the middle of the East River between Manhattan and Queens, the Filipino nurses started coming in earnest. In the 70’s, Filipino nurses were recruited for the two chronic care facilities on that little island. But in the 1980’s, the nursing shortage was at its worst. The Pinoy nurses were the city hospitals’ solution for the nursing crisis. With stars in our eyes and dreams in our hearts, we immigrated to the land of promise. After the first five Pinays came in 1982, there was an avalanche of nurses with about 100 nurses recruited from January to May of 1983 to work at Coler Memorial Hospital.

We are forever bonded by the experience of starting our nursing career in the United States. We struggled to adapt to a new life and culture. We had to learn the lingo, and I am almost certain that somebody else, aside from me, did not know that a Q-tip is a cotton applicator. My four years at Coler started me on a good path, and my memories of my first years are forever in my heart.

 

Sept. 30, 2023- Coler Filipino Nurses Grand Reunion at D’Haven Restaurant and Club.

And so we all came together to celebrate our beginnings, all 71 of us who answered the call from the organizers, the Glowing Gold Ladies. The nurses of Coler Hospital (retired and not) converged from far and wide- from California, Texas, Florida, and New Jersey. The out-of-towners brought their little sunshine to cheer the rain-drenched New Yorkers.

The Origs from 1982 were there. Then, the different batches of nurses who arrived in 1983 and beyond showed en force. So happy to reconnect with those who started life in the United States as young, naive, and eager nurses. A return to our wonder years, when life was challenging but simple. 

Thank you to the Glowing Gold Ladies for organizing such a massive and fun reunion. Thank you for the historical presentation about Coler, as well as showing our old pictures. At first, it was difficult to remember the names (getting old, you know) but the souvenir journal helped to clear the cobwebs in our minds. Love seeing familiar faces light up with recognition. Somehow, I am still Cerrudo for most.

And we got to celebrate our September birthdays again. I wish to have been able to collect some nursing stories from this group with their varied experiences. Collectively, we have a lifetime of memories to share. But tonight was for being young again and just having a good time. We started as colleagues, and we ended as a Coler family.

Oct. 1, 2023- Day 2 Coler Filipino Nurses picnic reunion at Cunningham Park sponsored by the energetic Glowing Gold Ladies. I bet that this dynamic group can do anything they set their minds to. Well, I have a proposition to them that I will talk about in a new blog post soon (this one). I came only for a short visit due to another appointment but I just wanted to bond again over our shared experiences when we started at Coler. The food was great, the music was infectious, and the camaraderie made this whole weekend such a momentous occasion.

 

 

We’ve come a long way.

Look at how far we've come; no more fumbling neophytes but confident and successful Pinoy and Pinay nurses. Back then, we were nervous, naïve, and unsure about our future in this foreign land.  Along the way, we forged our own paths, drawn by our interests and passions. We defined our own successes and chased our own rainbows. We stood on the shoulders of those who came before us, and we extended our support to those who came after us.

If we wrote a letter to our 1983 selves, we probably would have written several pages of advice. But we learned from our mistakes, and we grew stronger from the trial of fire. I made a meme of my younger self as I stood looking toward Manhattan, “Someday, you will retire. And you will know that you were a bad-ass nurse who cared for her patients and her colleagues.”

 

 

 

Writing our Stories

Ever since I can remember, I was always writing. As a nurse, my experiences since I started In Coler have given me a rich source of inspiration, and creative ideas, but most importantly, writing was my personal therapy. As a nurse educator, I learned that telling stories about my clinical experiences made my lessons relatable, and easier to understand.

In 2017, a patient reached out to me. I didn’t know him at all, but he read one of my blog posts. He wanted me to tell his story. He was facing major surgery after an unfortunate complication from a previous operation. He wrote, “I write to you to thank you for sharing all of your stories to exemplify how important nurses are in the most dire of situations. I would love to tell you of the many ways that the nurses made a difference in my care. How they comforted me when I was anxious; when I just needed someone to talk to.”

Our nursing stories do not have to be used only in classrooms. Our stories (poignant and sad, humorous and satirical, emotional and inspirational) can also be shared with the general public. Have we not often despaired that nurses are underrepresented in news stories and movies?

According to the Gallup poll, Nursing is the most trustworthy profession, but where is the hype about the impact of nursing? After the hero-worship during the peak of the pandemic, the balloon had deflated and healthcare workers, especially the nurses, are now even subjected to workplace violence.

I wrote in the preface of my book ER Nurse: The Warrior Within, “With my stories, I want to magnify the nurses’ voice, to define and exemplify the resilience of the front liners, I believe that there is always something in my stories that will resonate with any nurse or any caregiver. I hope to inspire future nurses and to reassure current nurses that they make a difference in somebody’s lives”.

As I was driving home before our grand reunion, I had an epiphany. The nurses of Coler have so many stories to tell, enough to share with the next generation of nurses who will rise up to the challenge of a new life away from home. The narratives would be rich and compelling for future nurses to learn from. Enough stories to fill another book, right?

 So my dear Coler mates, why don't we write our stories? Maybe an anthology of our first-year experiences, or our rise to the top? Maybe your love stories?

The First Funny Years in America

http://jo-cerrudo.blogspot.com/2023/01/the-first-funny-years-in-america.html

My Firsts... as a Nurse in the U.S.

http://jcerrudocreations.blogspot.com/search/label/firsts

 

Nursing... Thirty-One Years Ago

http://jo-cerrudo.blogspot.com/search/label/Coler%20Memorial%20Hospital

Kindness Matters

 

As a nurse, I see kindness daily from the healthcare workers. Even if they are short-staffed, they still treat their patients with utmost respect and care. During the height of the Covid-19 pandemic, the ache in my heart was eased by the kindness of the staff to their patients, and to each other.

In my previous hospital, a night nurse stayed beyond her shift to provide emotional support to an anxious, elderly nursing home patient awaiting surgery. I have always known that a heart of gold lies beneath the tough, no-nonsense exterior. She went above and beyond that day, recognizing that the feisty, belligerent patient was just scared.

Last week, a patient with explosive diarrhea slipped on the floor. He was morbidly obese, and he needed help to get back to his bed. He was obviously embarrassed, but a group of nurses and techs reassured him and cleaned him up quickly, without any fuss, and treated him with respect. When his family arrived, they saw a smiling patient, his dignity intact.

Despite the troubling news of crime and violence, some stories tug at my heart when I read about simple acts of decency and humanity. After a hard day's work, I do not want to read more of man's atrocities against their fellow men. I prefer to read feel-good stories. Maybe it’s a mindful exercise to positively fill my life, despite the challenges and adversities. Just like the personal protective equipment we use every day to protect us from contamination, I think that a daily dose of kind thoughts gives me the moral fortitude to carry on.

Last month, my friend Rosemarie wrote this when she picked up her son at the train station: “While I was sitting in my warm car, I noticed an older couple lying on the bench. The woman ensured the man was snuggled and wrapped tightly in a blanket and then secured herself. I have never seen homeless where I live, and seeing them struggle broke my heart. But watching their compassion for each other and knowing they were sitting in 30-degree weather. I realized I was sent to this train by my dad. I told them if they could walk a few blocks away while I waited for my son, I would make sure they would be safe at a hotel for the night with food. Twenty minutes later, when the room key was handed to me, I knew my dad sent me as he would always help anyone in need”.

Somebody messaged me yesterday on LinkedIn. I don’t know what I did precisely to merit such, but I appreciate the unexpected message from my former nurse. I was her head nurse in the ER 27 years ago. She thanked me for my kindness to her when she was a novice nurse in one of the busiest ERs in New York City.

When I came home today, I found a Thank you card from a former patient care technician who struggled to complete her nursing education while working. Because I saw her potential to be a compassionate nurse, I approved her request for flexible scheduling. In two years, she completed her accelerated program, graduated with her Bachelor’s degree, and later joined the ER as a full-fledged registered nurse.

Kindness matters. It is a gift to another human being; a gift that anyone can pay forward. I have received benevolent and selfless gestures from family, friends, and sometimes strangers. Angels in disguise, my lifeline when I needed support.

A random act of kindness can mean a whole world of difference to somebody at their saddest point. To a lonely person, a simple smile and a caring touch mean they matter. For someone in need, a helping hand may give them that fighting chance.

I resolve to make kindness a daily presence in my life. As other special people changed my life and showed me that there is light at the end of the tunnel, I want to be part of the wave of kindness for someone else. 

I am human, just like everybody else. Perfectly imperfect, but I try to live a good life. I make mistakes, but I will not consciously be unkind to somebody, nor I will I intentionally cause harm to anyone. I believe that for everything I do, blessings come back tenfold. 

Yes, kindness does matter. 

 

 

 

 

 

The First Funny Years in America

 

Forty years ago, in January 1983, I started my nursing career in America. 

A month ago, I found an old note I wrote on my first night on New York soil.  It was both a time of uncertainty and excitement for this new journey. It was exhilarating and yet tinged with homesickness. My first time away from home. I felt unprepared to be on my own, not knowing how to cook or do the laundry. Even though my family was not rich, we still managed to have a housemaid at home, mainly because my parents wanted me to concentrate on my studies.

I was young, adventurous, and full of dreams. Suddenly independent, suddenly an adult. 

Back then, nurses were only paid about $18,000 a year. I felt rich.

New friends

There was a small group of Filipino nurses who came before us in 1982. They were our mentors. Our group of 20 nurses was the first of many batches of recruits from the Philippines who settled in Coler Memorial Hospital, a long-term care facility in picturesque Roosevelt Island in New York. The influx of Filipino nurses was the city hospitals’ answer to the nursing shortage that gripped the US in the 1980s.

Coming to America was a culture shock. New to the country and new to the hospital system. The LPNs ruled the roost for a long time, so our advent was met with cynicism and hostility. We were young, bright-eyed, naïve, and ready to serve. Thankfully, the camaraderie among the Filipino nurses made us strong and united, and we were able to charm our way into our fellow staff members’ hearts. Somehow, the barriers came down and the LPNs and the RNs worked well together. It may be because we worked our asses off, as well as we were generous in sharing our food with everyone.

It was a whole new world for us. Most of us were in our twenties and we were ready to take on the world. But I was actually unprepared to be on my own in a foreign land. I was not domesticated at all; completely sheltered and spoiled. I never learned to cook, Thanks, Mom. I admit that my mom gave up on teaching me when I almost burned the house down when I tried to fry a fish or was it when I overboiled the egg?

We survived because we found humor in anything and everything.  Mostly we laughed at ourselves and at our clumsy ways to acclimate ourselves to our new lives. For our first month in New York, we were housed in a dorm near the hospital. We spent our nights comparing notes of our misadventures with each other. Soon, our funny stories were epic among our friends. These were funny moments that could have been great for a stand-up routine. If there was a female nurse Jokoy, it would have been one of us.

 

Accents/ Pronunciations

For any new immigrants to a new place, getting used to the accent, slang, and colloquialism is always a challenge. I sometimes got defensive in my mind when someone snickered at my mispronunciations. Isn’t it that research showed that those who are bilingual actually are intelligent people? So what if my tongue got twisted, at least my grammar was way better (modesty aside) than some of the native speakers.

On our second day in New York, my friends and I wanted to venture out to Manhattan to see the famous Bloomingdale’s and ride the Roosevelt Island tram. I approached the security officer in the hospital to ask for directions. I asked for a “map”. His face showed his confusion, but he gallantly gave me a “mop” that he borrowed from a passing housekeeper. 

Behind me, my friends were doubled up in laughter as they teased me, “long aaaa, use your long aaaa”. They were actually wrong because "map" has the soft 'a' sound like 'clap', and 'mop' has the soft 'o' sound like 'shop'.

The next day, I got my revenge. One of the doctors jumped in fear when he heard my friend ask the clerk if she saw her “bag”. The doctor thought my friend saw a “bug”, or as he called it, “Cucaracha!” Of course, I muttered to my friend, “Short 'a', use your short 'a' ”, exaggerated gesture and all. Soft vs short, how confusing. My gosh, it wasn’t easy to be “Americanized”.

One day, my head nurse sent me out to the Supply Room for some Q-tips. I was confident that I could figure it out because the bins were all labeled. For 15 minutes, I searched and could not find anything resembling a tip shaped like a "Q". I was almost in tears when the head nurse came into the room and grabbed the cotton applicators herself.

Cooking

After a month, our friends (Tess, Evelyn, Fe, and I) moved in together as roommates in a walk-up apartment in Steinway in Astoria, Queens. Hence, we were called the Steinway ladies. We shared cooking duties, but it was soon apparent that I did not have the talent to dice, slice, stir, and season the food to anything near palatable. My food experiments became fodder for jokes at our parties. 

For some, cooking relaxes them. Just the thought of having to come up with an edible dish stressed me and ruined my day off. My "monggo with sardines" never passed muster. By mutual agreement, and to the relief of all sides, I was assigned as the official dishwasher. Actually, it saved our friendship and my sanity.

First Blizzard

In February 1983, we experienced our first snow. The first snow crystals that came down from the skies were magical. I remembered sticking out my tongue and thanking God for finally experiencing what I only saw in the movies. I hugged a tree and did my first-ever “snow angel”.

The nice snow turned into a "Megalopolitan Blizzard" that buried New York with 2 feet of snow. We should have been hibernating in our cozy and warm apartment and enjoying our off days decorating our new place. But we needed a dining set. So, after the storm passed, we trudged through snow that came up to our thighs carrying the dinette and four chairs, about 2 blocks away from home. We should have been mortified at the cars honking at us, but we comforted ourselves that nobody would recognize us with the scarves covering our faces. It was a strange sight, indeed.

One day, I hang my hand-washed white pants outside our window to dry. The next day, it was stiff as a board. Because all my uniforms were still in the dirty hamper, I had no choice but to blow dry my pants. So, I came to work with my legs stiff, but at least, warm and toasty.

At the Laundromat, as told by Fe

“The first time we went to the laundromat for the first time, I panicked when I looked into the washer and could not find my clothes. I told Evelyn that my clothes were probably done so I climbed and looked at the back of the machine. I even asked the owner of the laundromat 'Where are my clothes?'. It’s good he did not understand me. Then, the machine stopped spinning, and like magic, my clothes were back.”

Bebs and her funny memories

Bebs was from another group called the Astoria Ladies. She said, “The funniest and scary moment was when I went to the World Trade Center with Malou. We wanted to send money home through the Philippine National Bank. Bagong salta sa Amerika. It was lunchtime then. Just imagine we were with all the businessmen either going to their office or whatever. The elevator was terrifyingly fast then I saw the sign “Press to stop”. In my curiosity (rather, my stupidity), I pressed the button. The elevator went to a sudden halt like there was an earthquake. Somebody called on the elevator phone, “A girl in the elevator pulled the emergency button”. My face turned red. What should have been only a few minutes to our destination floor took maybe 20 minutes to have the repairmen get the elevator back to normal operation. It was one of the most embarrassing experiences I had as a newbie here in the USA."

“Remember in the hospital cafeteria, we were being watched for using a spoon and fork to eat!!!?”

“When we went to use the public washing machine, I put too much detergent that the bubbles overflowed out of the top.”

“We fell in line in TKTS to see a movie; we thought that’s where to get movie tickets”.

Hey, Bebs! Don't forget that you posed like the University of the Philippines Oblation statue. 

East River flirting

During our first summer, my friends and I often hang out at the riverfront overlooking Manhattan. The skyline was magnificent, The towering buildings rising majestically against the blue skies. Sometimes, we waved at the bare-chested men on the boats as they sailed along the East River. 

I can only use the excuse that we were young, daring, and adventurous because we also threw kisses at the sailors, thinking we would never see them up close and personal. Until one boat motored up near the bank. We all scampered away like rabbits as if our mamas were after us with their slippers.

West Point

One of my fondest memories is that of Evelyn and Fe (former Steinway and later Broadway roommates) running down from the pier at the West Point Academy as the ferry boat sailed away back to NYC. It was my fault for being so distracted in the art museum that I missed the bus that was supposed to take us to the pier. At the last moment, they noticed that I did not make it to the bus. Tess had gone ahead with the other group and was unaware of my drama. 

So, Evelyn and Fe got off the bus and ran back to the museum to retrieve me. I thanked them profusely for not leaving me stranded on my lonesome, hahaha!  We were relieved that at least Fe had her Amex card so we were able to take the Amtrak train back to the city. It must have been me who clapped and shouted the loudest "We're now in New York" when the train conductor announced we were in Penn Station.

Christmas Tree, as told by Fe

"Evelyn and I went to Manhattan to see the Rockefeller Christmas tree. We took lots of pictures of a massive tree adorned with beautiful lights. It was when we got home that we realized that it was not THE Rockefeller tree."

Looking back, the first few years as we adjusted to our new lives were challenging, to say the least. We survived because we embraced all our experiences with gusto and with a sense of humor. Those were the days when life was simpler but exciting with new possibilities. 

In 1983, Karen Carpenter died of anorexia nervosa. Michael Jackson's Thriller went to no. 1 on the US 200 Billboard album. Lionel Richie's “You Are”, released in 1982, was the first song I heard on the radio. The MASH finale. The nursing shortage.

Forty years later, there is a nursing shortage again. I hope that those who will follow our steps will have as many laughs as we had.

It was 8509 miles and 20 hours of a turbulent plane ride, but I am here to stay.

 

My Firsts... as a Nurse in the U.S.

http://jcerrudocreations.blogspot.com/search/label/firsts

 

Nursing... Thirty-One Years Ago

http://jo-cerrudo.blogspot.com/search/label/Coler%20Memorial%20Hospital

Tasty and the Reluctant Cook

http://jcerrudocreations.blogspot.com/search/label/Reluctant%20cook

Joy on the Horizon

 

Just another busy shift. After a hard night's work, the staff nurses at a busy cardiac unit were preparing to head out. One of the nurses looked outside her patient's window on the 10th floor. She quickly summoned her co-worker Phillip Tubale, RN, who then snapped this breathtaking photo of the upcoming sunrise over the horizon, one of the many pictures Phillip had taken over the years, but this one is absolutely spectacular.

While most of New York City was sleeping, nature was showing off. The triumphant and vibrant colors were mesmerizing. The sky over Manhattan was emblazoned fiery red near the horizon and a sliver of yellow promising the coming of the glorious sun.

An instant mood-lifter. A much-needed Serotonin-booster. A joyful welcome to a new day. A million-dollar view.

The scientific phenomenon of the sun's rays bending through the atmospheric layers creates a gorgeous palette on the sky. The brain's orbitofrontal cortex responds to beautiful pictures of nature and helps reduce stress and anxiety. I bet my bottom dollar that sunrises brighten our dark days.  :) Here comes the sun. Joy in the horizon.

On that particular morning, the sunrise evoked feelings of joy, and in others who commented on Facebook, the picture brought them hope. I am confident that the nurses on 10East went home feeling energized, and I hope that the awesome display outside the window also inspired the patient. 

In the movie Collateral, Jamie Foxx is a taxi driver who dreams of establishing his own limousine business. Whenever he felt discouraged, he flipped his car visor and felt instantly calm and happy at the stunning picture of Maldives, with its overwater bungalows and crystal-clear lagoons.

It is not easy to be a nurse nowadays. The nurses' strike in major hospitals in New York was resolved, and we still wait with bated breath for the promise to become a reality. Amidst all these uncertainties, the frontliners struggle with the stressors of an increasingly demanding profession. To keep our mental well-being, we also need to seek our moments of joy.

At one of my classes with the nurses, I shared with them the photo album that I titled "Joy-triggers" (aside from my family):

• Pictures of sunrises and sunsets.
• Fall foliage.
• My favorite singers.
• Other random images that make me smile.

And soon, other nurses shared their pictures, and as I hoped they would, they shared the stories that gave them joy as nurses. Some were even teary-eyed as they recounted the emotional rewards of caring for their patients, despite the healthcare challenges that they face every day.

Finally, I showed the nurses a picture that kept me going during the Covid-19 pandemic while working in my previous hospital as a nursing director. A family with four kids from the community came to our Emergency Department to thank the staff for our service. They brought several pies of pizza with handwritten Thank You cards from the children. 

I still treasure those cards, to this day. 

My Happy Pictures: Mood-lifters

https://jcerrudocreations.blogspot.com/2022/11/my-happy-pictures-mood-lifters.html

 

Emergency Nurses Week 2022

In 1990, the first time I stepped into a city hospital Emergency Department (ED) and saw nurses and doctors rushing by what I thought was a frenzied scene, I almost threw up and ran away back to the chronic care facility I came from. The noise from the monitors, the sirens wailing on the ramp, the ringing of the telephones, and the curses from the intoxicated patients.  “This is not my world,” or so I thought.

After one perceptive nurse noticed my pale face, she tapped my shoulder and made me sit by her side at the Ambulance Triage while I waited for the nurse recruiter to return from an urgent phone call. She gave me a glass of water and entertained me with funny stories about the ED. “You haven’t seen anything yet.”, she teased me in her slight Indian accent, “but you will love it here. And you will never leave Emergency Nursing.”

“Sanni” was absolutely right. It is difficult to believe that I survived thirty-two years in emergency nursing. And loved the hurly-burly and exciting life of an ER nurse. And appreciated my colleagues through the years.

Like an arrow to the heart, emergency nursing lodged itself in my heart refusing to let go despite the adversities. I loved the staff and even craved the chaos. I stayed at Elmhurst Hospital for 21 years. Then, I worked in other urban EDs where life was never placid, never dull, and the word “Quiet” jinxes everything. My stay at Maimonides Medical Center and Mount Sinai Morningside provided me with a plentitude of stories and a lifetime of memories that strengthened me more as a nurse and as a person.

Never did it occur to me to leave the scary world of emergency nursing. The nursing, medical and ancillary staff in the ED stood resilient through the vagaries of demands from the patients in agony and despair. It was a world with emotional rewards because we made a difference. My career brought me from the bedside to several leadership positions, and I can honestly say that I enjoyed leaving a legacy of hard work, integrity, and fairness, I try.

Then the Covid-19 pandemic wrought emotional scars that brought me to the crossroads of my career. I almost walked away from nursing. I was emotionally bruised from feeling helpless and staying strong was a challenge. My body was keeping score.

According to the book by Bessel van der Kolk, the effects of trauma affect the emotions, the mind, and the physical body. He described hypervigilance and hyperarousal as causing physical ailments manifesting in the bodies of those who continue to suffer under stress. The constant adrenaline rush was wearing me down. My body was definitely keeping score, and it was giving me dire warnings to slow down, maintain my work-life balance, and do my self-care.

Life presented many trials on top of all the stressors we suffered with Covid. Realizing that I have to love myself first, I gave myself time to heal. My worth as a nurse and as a person is not tied to the insincere approvals from anybody, but to the overwhelming support and love from those who matter: the nurses whom I work with.

In 2021, I published my book “ER Nurse: The Warrior Within,  Bruised but still standing". This year 2022, the Emergency Nurses Association is formally celebrating Emergency Nurses Week on October 9 through October 15. It seems surreal that this year’s theme is “Standing Strong”.

I looked back at the pictures I collected over the thirty-two years and I smile with pride for having worked with my sisters and brothers on the battlefields. There are many psychological land mines in this profession. We have survived the storms and we will continue to weather the unpredictable and unprecedented challenges that come our way.

I cherish the camaraderie with the staff. I remember the fun moments and the simple pleasures that lightened our load. I treasure the hugs after a difficult day. I celebrate the lives we have saved and the thanks from patients and families for whom we made a difference. And most of all, I honor my fellow nurses on the front lines who inspire with their courage and resilience against all odds.

So, let’s continue to take care of ourselves first, find the time to enjoy our co-workers, and rejoice for the grace and blessings of caring for the sick and the injured. To the new nurses, especially those that I have personally taught in a nurse residency course in my new job, please hang in there. I hope that, many years later, you will look at these memories with fondness in your heart and gratitude for having touched countless lives.

Happy Emergency Nurses Week.

 

Recovering from Nurse Burn-out

(Published in the November 2022 issue of the Journal of Emergency Nursing under the title "Finding Joy: Fighting Nurse Burnout")

Finding Joy- JEN

At the beginning of April 2020, the Covid-19 pandemic burnt me out. At one point, I was ready to quit nursing. I wanted to run as far away as I could, away from dying patients, away from the heartaches.

I remember waking up in bed, physically drained from a fitful sleep, emotionally shattered by the friends and the patients we lost. I debated calling out sick that morning just because I dreaded hearing the frequent overhead pages for the code team.

The Apex of this pandemic that we were preparing for came much too early. Doctors, nurses, and techs were running around responding to calls for intubations, desperately trying to race against time. We were all covered from head to toe with impervious gowns, face shields, double gloves, boots, and surgical caps; the N95 masks would later leave marks on our faces. The scars in our hearts were unseen, PTSD a real threat.

We were protected, we assured ourselves, but how could you be confident about how safe you are when the Covid fatalities keep on rising? The whole hospital (and the whole city) was in a pandemic chokehold.

It took a few minutes of deep breaths before I could summon the courage to rise from my bed. For the first time in my long nursing career, I was at a crossroads I never thought I could ever be at. I considered myself unshakeable. “Been there, done that; nothing can ever make me turn away from Nursing,” or so I thought.

That morning, I felt burnt out, but I went to work. To fortify myself, I looked up onto the heavens and whispered, “My Lord God, take charge of my life.”

ON THE FRONTLINE

The New York streets were empty. The City that Never Sleeps was in total lockdown since March, and only the essential workers were allowed to travel. Along the Cross Bronx Expressway on my way to work, what was once a traffic nightmare looked more like an apocalypse with nary a car nor a truck in sight for miles on end. Times Square was a ghost town. The silence was both eerie and deafening. I felt like I was going to war, but I was scared and helpless. I hated being vulnerable.

I was on the frontline but felt like a spectator. I was not actually at the bedside giving direct care as I wanted to be. The responsibility of being a Director of Nursing in an emergency department amid a healthcare crisis was overwhelming, but not more than what the ED nurses, techs, medical providers, and other ancillary personnel had to go through. I can only imagine the enormous impact of the unending crisis on their psychological well-being when their best efforts sometimes fail.

My nurses forbid me to go into the rooms, even to help prepare the bodies for the Morgue. They wanted me safe. I even joked that I was not that old, that I could fight alongside them. Just like in Imposter Syndrome, I felt inadequate and not quite pulling my own weight on the battlefield.

All I could do was make rounds, check on the staff, order supplies, request the Incident Command for more staffing help, coordinate travel nursing coverage, handle family complaints, and act as a cheerleader and emotional support for the staff. I followed up with my quarantined staff members for Covid exposure and illness.  It was difficult to hear their anxiety and I feared that they could hear the quiver in my voice, so I preferred texting to phone calls. 

I saw the patients come through the Triage Area, with no family members to sit by their bedside. The patients were whisked directly to the rooms with high-flow oxygen masks to aid in their breathing. I saw patients inside the isolation room as they lay with apprehensive eyes looking at their oxygen saturation numbers on the cardiac monitors. 

I also remember the eyes of the ER staff beyond the masks and their face shields. Eyes that were sad and worried. Eyes haunted by the final goodbyes between the patients and their loved ones on the iPAD. Eyes filled with despair because of the unprecedented challenge wrought by the coronavirus onslaught. These were our darkest times.

I tried to be transparent with my information to the staff. But I grappled with what I could share. So, in my emails and our daily huddles, I talked about the nurse travelers coming in, the other non-clinical activities, and non-emergent procedures that were put on hold to deploy the staff to the ED and the other patient units. My news was upbeat and hopeful as I could possibly communicate to my already disheartened staff. I told them of the other surge capacity activities that the hospital leadership initiated to accommodate the influx of Covid-19 patients.

I did not share my concerns about the grim statistics and the dwindling supplies and equipment (since we compete with other hospitals for resources). I did not share that the Morgue was full and that there were Medical Examiner trailers on our campus. I did not confess that I wanted to quit nursing.

I did not want to stop and answer questions about my state of mind for fear that the tenuous hold on my fragile emotions would break. I did not want anyone to see me ugly-cry because of the sadness in my heart. So, I cried behind the doors.

 My priority was that my staff would feel supported so they could take care of the patients who needed their expert help. I had to be the leader that they deserved. I learned how to look confident on the outside, although I was frazzled on the inside. I could not afford to be weak.

EPIPHANY: SELF-CARE

The staff needed mental PPE. We corroborated with the Mental Health Liaison psychologists, who offered counseling and other options for the team to de-stress, decompress, and start healing our broken hearts. My epiphany was that I had to do self-care. How could I help my staff when I was running on empty?

In my personal life, through all life’s ups and downs, I relied on my family and friends, my church, and my writing to endure. I knew I was strong enough to survive my personal travails, but I was unsure if I could remain a nurse amid the challenges that had brought down my other colleagues. I resolved to look for my joy triggers at work. I knew I had to heal myself first before I could lead others.

One day, one nurse asked to speak with me. That nurse broke down crying as soon as we got into my office. The words of pain and despair poured out, and the repressed emotions from the past months finally tumbled out. The nurse was not suicidal but was profoundly sad and depressed. We talked for a long time, but mostly, I just listened. I called one of the mental health counselors and arranged an emergency visit. Then, we hugged, and the nurse thanked me for listening, and for being there. I am glad to report that today, that nurse is now healthy and is thriving well.

FINDING MY JOY 

Covid-19 would not be my downfall. Having witnessed the heroism and fortitude displayed by all healthcare personnel during these uncertain times made me realize how much I love the nursing profession. In my little way, I am privileged to have made a difference. That moment of indecision in my nursing career, that short period of burn-out, that temporary insanity is no longer. I have recovered my self-worth. I found my joy and my “why.”

What turned me around? What prevented me from leaving my profession? My healing came as I continued working as a nurse. I poured out my emotions into my daily journal, a catharsis to help me exorcise my negative feelings. My writing brought everything into perspective. Much as there were so many heartaches, I found comfort in our small triumphs. As a nurse, I was part of the army against this virus.

There were numerous things to celebrate. Let me count the reasons why we persevered:

• The clapping and appreciation from the hospital neighborhood and other heroes like the firemen and the cops.
• The outpouring of support from the community with unsolicited food deliveries (which both fed our bodies and our souls)
• The staff working as a team and caring for each other
• The staff comes in extra days so their peers will not work short-handed.
• The deployed staff working in unfamiliar places and doing their very best to help
• Dancing to the music “Call on Me” whenever a patient was discharged.
• Getting a Thank You from a patient and his family
• The staff rising to the challenge, despite the threat of Covid-19
• The knowledge that every single hospital employee was doing their best under the direst of circumstances
• The realization that we were doing God's work

I created a Facebook photo album of pictures from the staff to celebrate the resilient group that they are. It was a way to pay tribute and highlight this particular group on the frontlines of this war. I wanted to preserve in posterity the faces of the brave ones who came to fight the battle against Covid-19. 

The FB photo album grew into a photo journal. It was to chronicle the moments of levity captured in-between moments of heartbreak; just before they rush back to the unit to save more lives. Frozen in time, the pictures showed the ED team taking a much-deserved break, a respite from the hard work. Just a little breather. There was a spirit of camaraderie, of having bonded as we worked together. As time went on, the staff started to SMIZE, they smiled with their eyes.

These healthcare workers, heroes of my time, were simply inspiring.

Covid-19 Diaries, Part 1

Covid-19 Diaries, Part 2

NURSES’ MONTH

Last May 2020, the hospital managed to celebrate the Year Of The Nurse creatively despite the constraints of social distancing and face masks. We danced on the streets, gave out cookies and cupcakes, published our virtual nursing journal, enjoyed the gifts from numerous sponsors, and were treated to an aerial display from the US Air Force and the Navy. The festivities were a harbinger of hope that we would survive. The end of the pandemic would come. And then we prayed for the vaccine, our fighting chance.

 In 2022, the American Nurses Association chose the theme, “You Make A Difference.” Nurses in all disciplines and sectors truly matter as we give our patients a chance for a better life. Every Day. Our strength is rooted in determination and dedication to serving those who need help and fortified by the challenges and disruptions of the past years. 

Like every single nurse standing strong despite being bruised and shaken by our pandemic ordeal, I am still here. I am proud to be a nurse.

HAPPY NURSES' MONTH!!!